It is estimated that there are 1.2 million physicians of Indian Origin working in many countries of the world apart from India. There are 125,500 Physicians of Indian Origin working in the English speaking Western world (USA, UK, Australia and Canada combined), with the major constituent being from USA and UK. Between 10-30% of the physicians working in USA, UK, Canada and Australia have their roots in India. There are also significant number of Indian Physicians working in Middle East, South East Asia and Africa.
This substantial workforce of physicians is a valuable resource, which can help mobilize significant developments in the health field globally. This strong Diaspora of Indian doctors who are highly respected and powerful, need a common professional platform. There is a need for greater visibility and cohesion of these physicians. Their combined intellectual and technical strength can also be vital force in the development of the Indian healthcare sector.
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Kolkata: India is facing an epidemic of non-communicable diseases like diabetes, heart disease and cancer, according to Dr. Prathap C Reddy, chairman of Apollo Hospitals Group and founder president of Global Association of Physicians of Indian Origin (GAPIO).
“India is facing an epidemic of non-communicable diseases like diabetes, heart disease and cancer. It is estimated that by 2020, cardiovascular disease will be the cause of over 40 per cent deaths in India as compared to 24 per cent in 1990. By 2030, India will have the largest number of diabetic patients and will become the capital of diabetic patients in world. This is a dubious distinction that we do not need,” Dr Reddy said while speaking at a two-day international conference of GAPIO that began on January 11 here to discuss solutions in healthcare for improving health worldwide.
Addressing the delegates, Amit Mitra, minister of finance, commerce and industry, Govt of West Bengal, said he supported the idea of mass health insurance at a very low cost premium, availability of low cost generic medicines through public distribution system for public at large and role of telemedicine in providing healthcare to people in remote areas.
During the conference US-based gastroenterologist Dr Sanku Rao took over as president of GAPIO; UK-based paediatrician and neonatologist Dr Ramesh Mehta as vice president; Dr Anupam Sibal, paediatric gastroenterologist, hepatologist and group medical director of Apollo Hospitals, as secretary general Dr Nandakumar Jairam, chairman, Columbia Asia Hospitals, as joint secretary and US-based allergist and immunologist Dr Sudhir Parikh as treasurer.
Dr Rao informed the delegates that GAPIO had assisted in developing a web portal known as SwaasthIndia.com (www.swasthindia.in) in collaboration with American Association of Physicians of Indian Origin (AAPI), USA and British Association of Physicians of Indian Origin (BAPIO), UK to provide essential healthcare services at various locations in India with the help of doctors from India and overseas.
“The website will act as a matchmaking portal where Indian medical diaspora can view and apply for these opportunities put up on this portal by various state governments,” he said.
The conference was attended by over 300 delegates from India and overseas particularly from US, UK, Australia, Russia, Africa and Middle East. Renowned national and international faculty spoke at seven clinical sessions comprising of cardiac sciences, neurosciences, diabetes, gastroenterology and liver transplantation, robotics, nephrology/kidney transplantation and oncology, according to a statement by GAPIO.
At the conference Dr Sandip Mukerjee — Dr B C Roy National Awardee, former honorary surgeon to the President of India and past president of Delhi State Chapter, Association of Surgeons of India — and Dr Sudhir Parikh were honoured with the GAPIO Lifetime Achievement Awards. GAPIO Service Excellence Award was given to 14 GAPIO members.
GAPIO was envisaged by Dr Prathap Reddy; Dr Sanku Rao, past president, AAPI; and Dr Ramesh Mehta, president, BAPIO. It was launched in New Delhi in January 2011 to bring together 1.2 million physicians of Indian origin in the world on one professional platform. This substantial work force of physicians is a valuable resource, which can help to mobilize significant developments in the healthcare globally.
GAPIO has representation from 26 countries at present.
Global Association of Physicians of Indian Origin holds its annual conference in Kerala
Delegates across the globe will launch screening programs in non-communicable diseases which is set to achieve representation from 30 countries
Physicians of Indian origin from across the globe congregated at the third annual conference of Global Association of Physicians of Indian Origin (GAPIO) in Kochi, Kerala, with a vision to improve healthcare worldwide from 1st to 3rd January 2013. GAPIO was launched in January 2011 to bring together 1.2 million physicians of Indian origin in the world on one professional platform. This substantial workforce of physicians is a valuable resource, which can help to mobilize significant developments in the healthcare globally. GAPIO already has representation from 15 countries in the President’s Council.
Speaking on the occasion of 3rd Annual conference at Kochi, Dr. Prathap C Reddy, President, GAPIO said “establishing itself as an association of the Indian medical diaspora, GAPIO is marching ahead to impact global healthcare. The moment has arrived for the Indian doctor to take a lead in shaping the contours of global health scenario”.
GAPIO will launch a comprehensive screening program for non-communicable diseases in Chittoor district in Andhra Pradesh as a pilot which will then be replicated in other parts of the country according to Dr Reddy. GAPIO would like to work closely with the Government of India and different state governments in screening programs highlighted Dr Reddy.
Dr Sanku Rao, Vice President, GAPIO announced the plastic surgery program that will be held in Bilaspur, Chhattisgarh in January where more than 100 patients will undergo free surgery.
According to Dr. Ramesh Mehta, Secretary General, GAPIO, an exchange program to facilitate senior faculty exchange across institutions in India and other countries will also be launched this year.
“The President Council of GAPIO has resolved to draw a large number of members from the fields of research and academics this year to help achieve its objectives. GAPIO will also focus on encouraging young physicians to participate in exchange programs across the globe” said Dr Anupam Sibal Joint Secretary, GAPIO.
Having held conferences in Delhi, Birmingham, Hyderabad, New Jersey and Kochi, GAPIO will hold its 3rd midyear conference at Los Angeles in June 2013 to carry forward the agenda of the organisations. By the end of 2013, GAPIO will have representatives from more than 30 countries.
GAPIO – 3rd Midyear Conference – Anaheim California, USA
The conference started with Executive Committee meeting and followed with a reception dinner on 5th July. Dr. Sean Nikarwan made presentation on “Diabetes with Analog Treatment”.
During the meeting Executive Committee has constituted four awards to encourage members and coordinators for enrolling new members:
1. GAPIO Service Excellence Award (10 or more members between January to December)
2. GAPIO Emerging Young Leaders Award (25 or more members between January to December)
3. The GAPIO Leadership Award
4. The GAPIO Lifetime Achievement Award
These awards will be given during the Annual conference of GAPIO at Kolkata.
On second day, the opening session of General Body meeting started with welcome address by Dr. Sanku Rao. Secretary General Dr. Ramesh Mehta read the minutes of the previous General Body meeting held at Cochin and placed the audited accounts before the members which were unanimously approved. Secretary General also presented his report by making a presentation.
Dr. Anupam Sibal made a presentation regarding progress of Key GAPIO Projects. Dr. Lyndee Knox gave talk on project ECHO.
Many other prominent speakers covered various current healthcare challenges ranging from Childhood Obesity, Management of Hypertension, Twin epidemics of Diabetes and Heart Disease, IMR, Prevention of Blindness, Public Private Partnership and establishing rural healthcare in India.
GAPIO times issue II, a news letter of Global Association of Physicians of Indian Origin was released on this occasion. We shall be very shortly sending the news letter to all GAPIO members.
General Body meeting was followed by President’s reception and entertainment program by Geetanjali Group. Dr. Prem S. Reddy was the Chief Guest on this occasion.
Tuberculosis control needs a complete and patient-centric solution
Whether it is mobile phone service or vacation travel, good businesses know that success depends on providing a complete and customer-centric solution. Should patients with tuberculosis not be offered a complete solution that is patient-centred? After all, millions are affected and a large market at the base-of-the-pyramid (BoP) remains unserved. A complete and patient-centric solution will not only include care that meets the International Standards for Tuberculosis Care, but also be delivered with dignity and compassion, grounded in the reality of patients’ lives as they navigate the long pathway from symptoms to cure. Such solution-based innovation requires a systems-thinking approach that must place patients at the centre of design strategies, recognise their clinical and psycho-social needs, and be cost-effective. Because tuberculosis requires long-term treatment and involves many actors in the value chain, there needs to be an entity which, with appropriate financial support from external agencies, can orchestrate a complete solution that is affordable and locally accessible for patients. Are tuberculosis patients in high burden countries currently getting such a patient-centric solution? Let us consider India, which accounts for quarter of all tuberculosis cases in the world. Whether patients in India seek care in the public or the private sector, they struggle to get a complete solution. While the Revised National Tuberculosis Control Programme (RNTCP) has done well to reach scale and provide free diagnosis and treatment for patients with drug-sensitive disease in the public sector, the programme falls short in making sure that all patients get screened for drug-resistance and in ensuring adequate therapy for all patients with multidrug-resistant (MDR-TB) and extensively drug-resistant tuberculosis. Of the estimated 64,000 cases of MDR-TB in 2012, only 17,373 cases were diagnosed under the RNTCP. The diagnostic infrastructure in the public sector relies primarily on sputum smear microscopy that cannot detect drug resistance. It is only when patients fail to get better on standard treatment, or have recurrence of tuberculosis, that they get screened for MDR-TB, resulting in morbidity, continued transmission, and movement of patients from the public to the private sector. Recognising these problems, the RNTCP is actively scaling-up capacity to diagnose and treat MDR-TB. If adequately funded and successful, these initiatives should improve patient experience in the public sector. But the stark reality of tuberculosis in India is that 50% of all cases are managed in the private sector, where the quality of tuberculosis care is suboptimal with inaccurate diagnosis, non-standard drug prescriptions, and limited effort to ensure treatment adherence. Also, private practitioners often do not screen for drug-resistance and empirical antibiotic abuse is rampant. All this means drug resistance can emerge or worsen, with poor outcomes. Lastly, out-of-pocket expenditure in the private sector can be catastrophic. Are there examples of initiatives that address the above systemic problems? Operation ASHA is a non-governmental organisation that extends the RNTCP model, and uses public sector diagnostics and drugs, to orchestrate a solution by establishing community-based treatment centres and ensuring adherence using local community providers and partners. It also leverages biometrics to increase efficiency and effectiveness. It relies on donors and the public sector for funding. This social enterprise model, however, does not offer a solution to patients who seek care in the private sector. World Health Partners (WHP) is a donor-supported social marketing and social franchising model that delivers affordable reproductive and primary care (including tuberculosis) in underserved rural areas, by leveraging local entrepreneurs and informal providers, and by connecting them to the formal sector and specialists via telemedicine. Initiative for Promoting Affordable, Quality TB tests (IPAQT), a coalition of more than 60 private laboratories, supported by non-profits like the Clinton Health Access Initiative, has increased the availability and affordability of WHO-endorsed tuberculosis tests. Although IPAQT is addressing the problem of suboptimal diagnosis, it does not cover treatment. RNTCP recently announced “universal access to quality diagnosis and treatment for all tuberculosis patients in the community” as its goal in the new National Strategic Plan. Recognizing the need to leverage the private sector in developing a solution, the plan includes engagement of the private sector using “Public Private Interface Agencies” (PPIA) to enlist, sensitize, incentivize, and monitor diagnosis and treatment by private providers, to provide patient cost offsets such as subsidised diagnostics and free drugs to privately treated patients, and improve case notifications to the RNTCP. Ongoing PPIA pilot projects in Mumbai and Patna should inform policies for refinements and scale-up of this model. Outside of India, Operation ASHA is now replicating its model in Cambodia. In Bangladesh, BRAC’s tuberculosis programme with shasthya shebikas has been successful in the public sector. This model is now creating linkages with private providers. In addition, they have created partnerships with garment industry owners in export processing zones that provide factory workers with better access to tuberculosis diagnosis and treatment utilizing BRAC’s infrastructure. With donor support, Interactive Research and Development (IRD) and partners are expanding access to Xpert MTB/RIF (Cepheid Inc, CA), a WHO-endorsed test, in the private sector in Dhaka, Jakarta and Karachi, through mass verbal screening in private clinic waiting rooms, and referrals for computer-aided digital X-ray diagnosis. This model includes management of comorbid conditions such as diabetes and chronic obstructive pulmonary disease, to generate revenue for this social enterprise. All these models are promising, but the goal of a complete, patient-centric solution is still elusive. Continued innovation in the development of scalable, sustainable and replicable business models to provide such solutions is critical. To improve accessibility and affordability, many of the models will depend on community workers and coordinators, underscoring the need for well-designed strategies for their recruitment, training, incentivization, and performance management. Information and communications technologies will also be critical for success. Solution-centric approaches have shown promise in several other BoP contexts, from affordable eye care to artificial limbs. By using product and process innovations, often with community champions, these models have shown that it is possible to serve the BoP market needs effectively and efficiently and with compassion and dignity. Individuals with tuberculosis deserve nothing less. .
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